Associations between Food Security Status and Diet-Related Outcomes among Students at a Large, Public Midwestern University.

Food insecurity is a growing issue of concern on college campuses. While many studies have focused on predictors of food insecurity, fewer studies have examined how food insecurity affects diet and diet-related outcomes among college students. The objective of this study was to examine differences in dietary intake, food and cooking agency, and body mass index (calculated as kg/m2) by food security status in a sample of college students at a large, public midwestern university. We conducted a cross-sectional online survey administered from March to June 2018. Students were recruited from a random sample (n=2,000) provided by the university, which included an oversample of minority racial/ethnic students from lower-income households and first-generation students. The response rate was 43% (n=851). After excluding students with missing data, the final sample was 754 enrolled students. Food security status was measured using the US Adult Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute dietary screener questionnaire. Cooking and food agency was measured using the Cooking and Food Provisioning Action Scale, a new validated questionnaire. Body mass index was calculated from self-reported height and weight. Differences between food security categories and diet-related outcomes were examined using generalized linear models. Models adjusted for sociodemographic covariates, such as student's age, sex, race/ethnicity, and receipt of financial aid. Compared to students with high food security, low food security was associated with lower intake of fruits, and very low food security was associated with higher intakes of total added sugar and added sugar from sugar-sweetened beverages. Marginal and very low food security were positively associated with body mass index. Marginal, low, and very low food security were inversely associated with cooking and food agency. Students with food insecurity experience diet-related challenges that could translate into health disparities over time. More research is needed to understand the longitudinal effects of food insecurity on student health and well being.

Leung CW ，Wolfson JA ，Lahne J ，Barry MR ，Kasper N ，Cohen AJ ... -  《Journal of the Academy of Nutrition and Dietetics》

Food Insecurity and Dietary Intake among College Students with Unlimited Meal Plans at a Large, Midwestern University.

Food insecurity, a state of not being able to consistently access nutritious food due to financial constraints, has been associated with poor dietary intake among college students. The extent to which campus food resources contribute to this association is unknown. This study examined the association between food insecurity and dietary intake in a sample of undergraduate students with unlimited meal plans and dining hall access at a large, public Midwestern university. The study design is cross-sectional. The data used are baseline data from a broader sugar-sweetened beverage intervention study that were collected using a Qualtrics survey prior to the intervention. The sample consisted of 1033 undergraduate students recruited from 3 dining halls. The data were collected in November 2018. Food security was assessed using the 6-item Short Form Food Security Survey Module. Dietary intake was assessed using the National Cancer Institute 26-item Dietary Screener Questionnaire and the Beverage Intake Questionnaire-15. Generalized linear regression models were used to examine differences in dietary intake by students' food security status, adjusting for students' sociodemographic characteristics. In the sample, 14% of students were food-insecure. After adjusting for sociodemographic variables, food-insecure students reported 9% lower intake of fruits (P = 0.02), 9% lower intake of vegetables (P < 0.001), 10% higher intake of dairy (P = 0.002), 6% higher intake of total added sugars (P = 0.01), 10% higher intake of added sugars from sugar-sweetened beverages (P = 0.01), 4% higher intake of calcium (P = 0.01), and 4% lower intake of fiber (P = 0.01) compared with food-secure students. With respect to beverage intake, food-insecure students had 56% higher intake of total sugar-sweetened beverages (P = 0.002), which was driven by 185% higher intake of energy and sports drinks (P = 0.001), and 121% higher intake of sweetened teas (P = 0.001). Despite having identical food resources within campus dining halls, there were significant differences in the diets of college students by food security status.

Mei J ，Fulay AP ，Wolfson JA ，Leung CW ... -  《Journal of the Academy of Nutrition and Dietetics》

Students with Food Insecurity Are More Likely to Screen Positive for an Eating Disorder at a Large, Public University in the Midwest.

College students experience a disproportionately high prevalence of both food insecurity and eating disorders. Food insecurity is associated with stress, irregular eating patterns, weight change, depression, and body dissatisfaction, making it a possible risk factor for the onset of eating disorders. However, the association between food insecurity and eating disorders among college students is not well understood. This study explored the relation between food insecurity and screening positive for an eating disorder among students attending a large, public Midwestern university. Cross-sectional data were collected using an online survey administered from March through June 2018. Participants were recruited from a random sample of 2,000 students, with oversampling from the following groups: racial/ethnic minorities, first-generation students, and students from lower-income households. Of those sampled, 851 students (43%) responded. The final analytic sample comprised 804 students after excluding those with missing data. The validated 5-item Sick, Control, One stone, Fat, Food (SCOFF) questionnaire was used to screen for the presence of an eating disorder. Poisson regression was used to model prevalence ratios for positive SCOFF screens (≥2 affirmative responses) by levels of food security (ie, high, marginal, low, or very low). Models were adjusted for sex, age, race/ethnicity, degree type, financial aid, and first-generation student status. Compared to students with high food security, a higher prevalence of positive SCOFF screens was found among students with marginal food security (prevalence ratio [PR], 1.83, 95% CI 1.26 to 2.65; P = 0.001), low food security (PR 1.72, 95% CI 1.16 to 2.54; P = 0.007), and very low food security (PR 2.83, 95% CI 2.01 to 3.97; P < .0001). Students with food insecurity at any level were more likely to screen positive for an eating disorder via the SCOFF questionnaire. Prospective studies are needed to determine whether food insecurity is a risk factor for the onset of eating disorders among college students.

Barry MR ，Sonneville KR ，Leung CW 《Journal of the Academy of Nutrition and Dietetics》

Diet Quality and Fruit, Vegetable, and Sugar-Sweetened Beverage Consumption by Household Food Insecurity among 8- to 12-Year-Old Children during Summer Months.

Lee J ，Kubik MY ，Fulkerson JA 《Journal of the Academy of Nutrition and Dietetics》

The Association Between Food Insecurity and Dietary Outcomes in University Students: A Systematic Review.

University students may experience a high prevalence of food insecurity. The impacts of food insecurity on dietary intake and meal patterns of students have not been fully researched. This systematic review aimed to examine the association between food insecurity and dietary outcomes among university students. Nine electronic databases and gray literature were searched from their inception to July 2020. Studies that reported dietary outcomes in both food-secure and -insecure students or the association between food insecurity and dietary outcomes among current students in tertiary education settings in any country were included. All study designs were eligible for inclusion, except qualitative studies. Two reviewers completed the screening, data extraction, and quality assessment independently. Study quality was assessed using the Joanna Briggs Institute appraisal tools. Sixteen studies were included in the final qualitative synthesis of this review. Most studies were cross-sectional designs and of fair quality. The prevalence of food insecurity among university students ranged from 21% to 82% across studies. Lower intakes of healthy foods (eg, fruits, vegetables, and whole grains) and higher intakes of unhealthy foods (eg, fast foods, added sugars, and sugar-sweetened beverages) were observed in food-insecure students, and studies with the most representative samples of the student body found these trends. Some food-insecure students consumed breakfast and evening meals less frequently than food-secure students but the evidence was limited. Validated food security and dietary assessment tools were inconsistently used to assess diet quality among students with differing food security status. The heterogeneity of student sampling and data collection may contribute to inconsistent findings. Poorer dietary outcomes were found in university students with food insecurity compared with food-secure students, but statistical significance was only observed in a small number of studies. Future longitudinal studies using food security and dietary assessment tools validated in this population are recommended to confirm the observed associations between food insecurity and diet quality among university students.

Shi Y ，Davies A ，Allman-Farinelli M 《Journal of the Academy of Nutrition and Dietetics》